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Chirita D, Bronnec P, Magnotti F, Dalmon S, Martin A, Popoff M, Gerfaud-Valentin M, Sève P, Belot A, Contis A, Duquesne A, Nocturne G, Lemelle I, Georgin-Lavialle S, Boursier G, Touitou I, Jamilloux Y, Henry T. Mutations in the B30.2 and the central helical scaffold domains of pyrin differentially affect inflammasome activation. Cell Death Dis 2023; 14:213. [PMID: 36966139 PMCID: PMC10039897 DOI: 10.1038/s41419-023-05745-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 03/27/2023]
Abstract
Familial Mediterranean Fever (FMF) is the most common monogenic autoinflammatory disorder. FMF is caused by mutations in the MEFV gene, encoding pyrin, an inflammasome sensor. The best characterized pathogenic mutations associated with FMF cluster in exon 10. Yet, mutations have been described along the whole MEFV coding sequence. Exon 10 encodes the B30.2 domain of the pyrin protein, but the function of this human-specific domain remains unclear. Pyrin is an inflammasome sensor detecting RhoA GTPase inhibition following exposure to bacterial toxins such as TcdA. Here, we demonstrate that the B30.2 domain is dispensable for pyrin inflammasome activation in response to this toxin. Deletion of the B30.2 domain mimics the most typical FMF-associated mutation and confers spontaneous inflammasome activation in response to pyrin dephosphorylation. Our results indicate that the B30.2 domain is a negative regulator of the pyrin inflammasome that acts independently from and downstream of pyrin dephosphorylation. In addition, we identify the central helical scaffold (CHS) domain of pyrin, which lies immediately upstream of the B30.2 domain as a second regulatory domain. Mutations affecting the CHS domain mimic pathogenic mutations in the B30.2 domain and render the pyrin inflammasome activation under the sole control of the dephosphorylation. In addition, specific mutations in the CHS domain strongly increase the cell susceptibility to steroid catabolites, recently described to activate pyrin, in both a cell line model and in monocytes from genotype-selected FMF patients. Taken together, our work reveals the existence of two distinct regulatory regions at the C-terminus of the pyrin protein, that act in a distinct manner to regulate positively or negatively inflammasome activation. Furthermore, our results indicate that different mutations in pyrin regulatory domains have different functional impacts on the pyrin inflammasome which could contribute to the diversity of pyrin-associated autoinflammatory diseases.
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Affiliation(s)
- Daria Chirita
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France
| | - Pauline Bronnec
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France
| | - Flora Magnotti
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France
| | - Sarah Dalmon
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France
| | - Amandine Martin
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France
| | | | - Mathieu Gerfaud-Valentin
- Department of Internal Medicine, University Hospital Croix-Rousse, Lyon 1 University, Lyon, France
| | - Pascal Sève
- Department of Internal Medicine, University Hospital Croix-Rousse, Lyon 1 University, Lyon, France
| | - Alexandre Belot
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France
- LIFE, Lyon Immunopathology FEderation, Lyon, France
- Department of Pediatric Nephrology, Rheumatology, Dermatology, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Femme Mère Enfant, CHU Lyon, Bron, France
| | - Anne Contis
- Department of Internal Medicine, Saint André Hospital, CHU Bordeaux, Bordeaux, France
| | - Agnes Duquesne
- Department of Pediatric Nephrology, Rheumatology, Dermatology, Reference centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Hôpital Femme Mère Enfant, CHU Lyon, Bron, France
| | - Gaetane Nocturne
- Department of Rheumatology, Université Paris-Saclay, INSERM UMR1184: Center for immunology of viral infections and autoimmune diseases, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Irene Lemelle
- Paediatric onco-haematology, University Hospital of Nancy - Children's hospital, Vandoeuvre-Lès-Nancy, France
| | - Sophie Georgin-Lavialle
- Sorbonne University, department of internal medicine, Tenon hospital, DMU 3ID, AP-HP, National reference center for autoinflammatory diseases and inflammatory Amyloidosis (CeRéMAIA), INSERM U938, Paris, France
| | - Guilaine Boursier
- Department of Molecular genetics and Cytogenomics, CHU Montpellier, Univ Montpellier, Reference Center for Autoinflammatory Diseases and Amyloidosis (CeRéMAIA), Montpellier, France
| | - Isabelle Touitou
- Department of Molecular genetics and Cytogenomics, CHU Montpellier, Univ Montpellier, Reference Center for Autoinflammatory Diseases and Amyloidosis (CeRéMAIA), Montpellier, France
| | - Yvan Jamilloux
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France
- Department of Internal Medicine, University Hospital Croix-Rousse, Lyon 1 University, Lyon, France
- LIFE, Lyon Immunopathology FEderation, Lyon, France
| | - Thomas Henry
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, LYON, France.
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Hadjadj J, Canzian A, Karadag O, Contis A, Maurier F, Sanges S, Sartorelli S, Denis L, de Moreuil C, Durel CA, Durupt S, Jachiet M, Rouzaud D, Salvarani C, Padoan R, Dagna L, Bonnet F, Agard C, Moulinet T, Hermet M, Sterpu R, Maria ATJ, Keraen J, Guillevin L, Jayne D, Terrier B. Use of biologics to treat relapsing and/or refractory polyarteritis nodosa: data from a European collaborative study. Rheumatology (Oxford) 2022; 62:341-346. [PMID: 35686919 DOI: 10.1093/rheumatology/keac332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/12/2022] [Accepted: 05/27/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To describe the effectiveness and safety of biologics for the treatment of relapsing and/or refractory polyarteritis nodosa (PAN). METHODS A retrospective European collaborative study was conducted in patients with PAN who received biologics for relapsing and/or refractory disease. RESULTS Forty-two patients with PAN received a total of 53 biologic courses, including TNF-α blockers in 15 cases, rituximab (RTX) in 18 cases, tocilizumab (TCZ) in 10 cases and other biologics in 10 cases. TNF-α blockers and TCZ were mainly used for refractory diseases whereas RTX was mainly initiated for relapsing disease. After a median follow-up of 29 (8-50) months, remission, partial response, treatment failure and treatment discontinuation due to severe adverse events occurred in, respectively, 40%, 13%, 40% and 7% of patients receiving TNF-α blockers, 50%, none, 30% and 20% of TCZ recipients, and 33%, 11%, 56% and none of the RTX recipients. No remission was noted in patients treated with other biologics. Severe adverse events were observed in 14 (28%) patients without significant differences between the three biologics, leading to early biologics discontinuation in only three cases. CONCLUSION These results suggest that TCZ may be effective in relapsing and/or refractory PAN. Our data warrant further study to confirm these findings.
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Affiliation(s)
- Jérome Hadjadj
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP-CUP, Hôpital Cochin, Paris, France
| | - Alice Canzian
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP-CUP, Hôpital Cochin, Paris, France
| | - Omer Karadag
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Vasculitis Research Centre, Hacettepe University, Ankara, Turkey
| | - Anne Contis
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, Bordeaux
| | - François Maurier
- Department of Internal Medicine and Immunology, Groupe Hospitalier UNEOS, Metz-Vantoux
| | - Sébastien Sanges
- Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE-Institute for Translational Research in Inflammation, Lille, France
| | - Silvia Sartorelli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Cécile-Audrey Durel
- Department of Internal Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon
| | - Stéphane Durupt
- Department of Internal Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon.,Service de Médecine Interne, Centre Hospitalier Universitaire Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite
| | | | - Diane Rouzaud
- Département de Médecine Interne, Hôpital Bichat, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Carlo Salvarani
- Rheumatology Unit, Dipartimento Medicina Interna e Specialità Mediche, Azienda Unità Sanitaria Locale di Reggio Emilia-Istituto di Ricerca e Cura a Carattere Scientifico, Reggio Emilia
| | - Roberto Padoan
- Division of Rheumatology, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Fabrice Bonnet
- Department of Internal Medicine and Infectious Diseases, Bordeaux University Hospital, Saint André Hospital, Bordeaux
| | - Christian Agard
- Internal Medicine Department, Nantes Université, CHU Nantes, Nantes
| | - Thomas Moulinet
- Department of Internal Medicine and Clinical Immunology, Center de Compétence des Maladies Autoimmunes Systémiques Rares, CHU Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France; UMR 7365, IMoPA, University of Lorraine, CNRS, Nancy
| | - Marion Hermet
- Service de Médecine Interne, Centre Hospitalier, Vichy
| | - Raluca Sterpu
- Service de Médecine Interne, Immunologie Clinique, Médecine Aigüe Polyvalente, Hôpital Antoine-Béclère-AP-HP, Clamart
| | - Alexandre Thibault Jacques Maria
- Department of Internal Medicine and Multiorgan Diseases, Referral Center for Auto-immune Diseases, Saint-Eloi Hospital Montpellier University, Montpellier
| | - Jérémy Keraen
- Service de Médecine Interne, Centre Hospitalier Cornouaille, Quimper, France
| | - Loic Guillevin
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP-CUP, Hôpital Cochin, Paris, France
| | - David Jayne
- Service de Médecine Interne, Centre Hospitalier Cornouaille, Quimper, France
| | - Benjamin Terrier
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP, APHP-CUP, Hôpital Cochin, Paris, France
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Le TTT, Martinent G, Dupuis-Girod S, Parrot A, Contis A, Riviere S, Chinet T, Grobost V, Espitia O, Dussardier-Gilbert B, Alric L, Armengol G, Maillard H, Leguy-Seguin V, Leroy S, Rondeau-Lutz M, Lavigne C, Mohamed S, Chaussavoine L, Magro P, Seguier J, Kerjouan M, Fourdrinoy S. Development and validation of a quality of life measurement scale specific to hereditary hemorrhagic telangiectasia: the QoL-HHT. Orphanet J Rare Dis 2022; 17:281. [PMID: 35854330 PMCID: PMC9295423 DOI: 10.1186/s13023-022-02426-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/30/2022] [Indexed: 12/01/2022] Open
Abstract
Background Hereditary hemorrhagic telangiectasia (HHT) disease is a rare genetic disorder with symptoms and complications that can significantly affect patients’ daily lives. To date, no scale has been validated to assess the specific symptoms of this disease on the quality of life (QOL) of HHT patients. This makes it difficult for clinicians to accurately measure the quality of life of patients with HHT. The present study aims to develop and validate a QOL measurement tool specific to HHT disease: the QOL questionnaire in HHT (QoL-HHT). Methods A quantitative, non-interventional, multi-center study involving HHT patients in twenty French HHT expert centers was conducted. A calibration sample of 415 HHT patients and a validation sample of 228 HHT patients voluntarily participated in the study. Data were analyzed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Exploratory Structural Equation Modeling (ESEM) analyses, reliability analyses, and correlational analyses. Results The EFA, CFA and ESEM results allowed us to provide evidence of the factorial structure of a questionnaire composed of 24 items measuring 6 domains of QOL: Physical limitations, social relationships, concern about bleeding, relationship with the medical profession, experience of symptoms, and concern about the evolution of the disease. Cronbach’s alpha coefficients (> 0.70) demonstrated reliable internal consistency of all the QoL-HHT scores (dimensions). The results of the test–retest provided further evidence of the reliability of the QOL-HHT scores over time. Correlational analyses provided evidence for the convergent validity of the QoL-HHT scores. Conclusions We developed a simple and quick self-assessment tool to measure quality of life specific to HHT disease. This study demonstrated reliability and validity of our QoL-HHT scores. It is a very promising tool to evaluate the impact of HHT disease on all aspects of the quality of life of HHT patients in order to offer them individualized medico-psycho-social support. Trial registration: ClinicalTrials, NCT03695874. Registered 04 October 2018, https://www.clinicaltrials.gov/ct2/show/NCT03695874 Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02426-2.
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Affiliation(s)
- Thi Thao Truc Le
- Laboratoire de Psychologie sur les Dynamiques Relationnelles et Processus Identitaires (EA 7458), Université de Bourgogne-Franche-Comté, 3 Allée des Stades Universitaires, 21000, Dijon, France
| | - Guillaume Martinent
- Laboratoire sur les Vulnérabilités et l'Innovation dans le Sport (EA 7428), Université de Lyon, Université Claude Bernard Lyon 1, 27-29 bd du 11 Novembre 1918, 69622, Villeurbanne, France
| | - Sophie Dupuis-Girod
- Service de génétique clinique, Centre de Référence pour la Maladie de Rendu-Osler, Hospices Civils de Lyon, HFME Bâtiment A1, 59 bd Pinel, 69677, Bron Cedex, France
| | - Antoine Parrot
- Service de pneumologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de Chine, 75790, Paris Cedex 20, France
| | - Anne Contis
- Service de médecine interne, Hôpital Saint André, 1 rue Jean Burguet, 33000, Bordeaux, France
| | - Sophie Riviere
- Service de médecine interne, CHU de Montpellier Hôpital St Eloi, Avenue A. Fliche, 34295, Montpellier Cedex 5, France
| | - Thierry Chinet
- Consultation Maladie de Rendu-Osler, CHU Ambroise Paré, 9 av Charles de Gaulle, 92104, Boulogne Billancourt, France
| | - Vincent Grobost
- Service de médecine interne, CHU Estaing, 1 rue Lucie et Raymond Aubrac, 63100, Clermont-Ferrand, France
| | - Olivier Espitia
- Service de médecine interne - médecine vasculaire, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France
| | | | - Laurent Alric
- Service de médecine interne, CHU Rangueil, 1 av du Pr Jean Poulhès, 31059, Toulouse Cedex 9, France
| | - Guillaume Armengol
- Service de médecine interne, CHU de Rouen Ch. Nicolle, , 1 rue de Germont, 76031, Rouen Cedex, France
| | - Hélène Maillard
- Service de médecine interne, Hôpital Huriez, 1 rue Michel Polonovski, 59037, LILLE Cedex, France
| | - Vanessa Leguy-Seguin
- Service de médecine interne, Hôpital Le Bocage, 2 Bd Maréchal de Lattre de Tassigny, BP 77908, 21079, Dijon Cedex, France
| | - Sylvie Leroy
- Service de pneumologie, CHU de Nice, 30 av de la Voie Romaine, 06002, Nice Cedex, France
| | - Murielle Rondeau-Lutz
- Service de médecine interne, CHU de Strasbourg Nouvel Hôpital Civil, 1 place de l'Hôpital, 67000, Strasbourg, France
| | - Christian Lavigne
- Service de médecine interne, CHU d'Angers, 4 rue Larrey, 49933, Angers Cedex 09, France
| | - Shirine Mohamed
- Service de médecine interne, CHU de Nancy, Hôpital Brabois, Rue du Morvan, 54511, Vandoeuvre Les Nancy, France
| | - Laurent Chaussavoine
- Service de médecine vasculaire, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France
| | - Pascal Magro
- Service de pneumologie, CHRU de Tours Hôpital Bretonneau, 2 bd Tonnellé, 37044, Tours Cedex 9, France
| | - Julie Seguier
- Service de médecine interne, Hôpital de La Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France
| | - Mallorie Kerjouan
- Service de pneumologie, CHU de Rennes Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes Cedex 09, France
| | - Sylvie Fourdrinoy
- Service de génétique clinique, Centre de Référence pour la Maladie de Rendu-Osler, Hospices Civils de Lyon, HFME Bâtiment A1, 59 bd Pinel, 69677, Bron Cedex, France.
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Devé K, Lapoirie J, Contis A, Bonnet F, Vandenhende M. Le fruit d’un champignon. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Canu D, Lazaro E, Machelart I, Riviere E, Viallard J, Contis A, Richez C, Seneschal J, Doutre M. Belimumab et atteintes cutanées du lupus – Étude prospective de 12 patients. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jean A, Monier A, Contis A, Chaussade H, Bonnet F. Maladie associée aux IgG4 avec atteinte ostéo-médullaire : à propos d’un cas. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Papo M, Friedrich C, Delaval L, de Boysson H, Viallard JF, Bachmeyer C, Sené T, Humbert S, Duffau P, Contis A, Agard C, Gombert B, Puyade M, Foucher A, Alary AS, Danlos FX, Régent A, Mouthon L, Guillevin L, Samson M, Kosmider O, Terrier B. Myeloproliferative neoplasms and clonal hematopoiesis in patients with giant cell arteritis: a case-control and exploratory study. Rheumatology (Oxford) 2021; 61:775-780. [PMID: 33836046 DOI: 10.1093/rheumatology/keab337] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/02/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Giant cell arteritis (GCA) is a large vessel vasculitis for which triggering factors remain unknown. Clonal hematopoiesis (CH) was associated with atherosclerosis through the induction of inflammation in myeloid cells, and data suggest that CH expansion and inflammation may support each other to induce a proinflammatory loop. Our objective was to describe the impact of JAK2p.V617F-mutated myeloproliferative neoplasms (MPN) on GCA and to screen MPN-free patients for CH mutations. METHODS We performed a retrospective case-control study comparing characteristics of 21 GCA patients with MPN and 42 age and gender-matched GCA patients without MPN. Also, 18 GCA patients were screened for CH through Next Generation Sequencing. RESULTS The most frequent associated MPN was essential thrombocythemia (ET) (n = 11). Compared to controls, GCA patients with MPN had less frequent cephalic symptoms (71.4 vs. 97.6%, p = 0.004) and higher platelets count at baseline [485 (346-586) vs. 346 [IQR 296-418] x 109/L, p = 0.02). There was no difference between groups for other clinical features. Overall survival was significantly shorter in patients with MPN compared to controls [HR 8.2 (95% CI 1.2-56.6), p = 0.03]. Finally, screening for CH using NGS in 15 GCA patients without MPN revealed CH in 33%. CONCLUSION GCA patients with MPN display higher platelets count and shorter overall survival than controls. This association could not be fortuitous given the possible pathophysiological relationship between the two diseases. CH was found in one third of GCA patients, which may be higher than the expected prevalence for similar age, what should be confirmed in a larger cohort.
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Affiliation(s)
- Matthias Papo
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Chloé Friedrich
- Laboratory of Hematology, Cochin Institute, Paris University, AP-HP, Paris, France
| | - Laure Delaval
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Hubert de Boysson
- Department of Internal Medicine, UNICAEN, EA4650 SEILIRM, Caen Normandie University Hospital, Caen, France
| | - Jean-François Viallard
- Department of Internal Medicine and Infectious Diseases, Haut Lévêque University Hospital, Bordeaux University, Pessac, France
| | - Claude Bachmeyer
- Department of Internal Medicine, AP-HP, Tenon Hospital, Sorbonne University, Paris, France
| | - Thomas Sené
- Department of Internal Medicine, Rothschild Foundation Hospital, Paris, France
| | - Sébastien Humbert
- Internal Medicine Department, University Hospital Besancon, Besançon, France
| | - Pierre Duffau
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France; CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France
| | - Anne Contis
- Department of Internal Medicine and Clinical Immunology, Saint Andre Hospital, University Hospital Centre of Bordeaux, 33000 Bordeaux, France; CNRS UMR 5164, Immuno ConcEpT, Bordeaux University, 33076 Bordeaux, France
| | | | - Bruno Gombert
- Department of Rheumatology, La Rochelle Hospital, La Rochelle, France
| | - Mathieu Puyade
- Department of Internal Medicine and Infectious Diseases, Poitiers Universitary Hospital, Poitiers, France
| | - Aurélie Foucher
- Department of Internal Medicine, CHU de La Réunion, Saint Pierre, France
| | - Anne-Sophie Alary
- Laboratory of Hematology, Cochin Institute, Paris University, AP-HP, Paris, France
| | - François-Xavier Danlos
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Alexis Régent
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Luc Mouthon
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Loïc Guillevin
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Bourgogne-Franche-Comté, Dijon, France
| | - Olivier Kosmider
- Laboratory of Hematology, Cochin Institute, Paris University, AP-HP, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, Cochin Hospital, National Referral Center for Rare Systemic Autoimmune Diseases, Paris University, Paris, France
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Felten R, Devauchelle-Pensec V, Seror R, Duffau P, Saadoun D, Hachulla E, Pierre Yves H, Salliot C, Perdriger A, Morel J, Mékinian A, Vittecoq O, Berthelot JM, Dernis E, Le Guern V, Dieudé P, Larroche C, Richez C, Martin T, Zarnitsky C, Blaison G, Kieffer P, Maurier F, Dellal A, Rist S, Andres E, Contis A, Chatelus E, Sordet C, Sibilia J, Arnold C, Tawk MY, Aberkane O, Holterbach L, Cacoub P, Saraux A, Mariette X, Meyer N, Gottenberg JE. Interleukin 6 receptor inhibition in primary Sjögren syndrome: a multicentre double-blind randomised placebo-controlled trial. Ann Rheum Dis 2021; 80:329-338. [PMID: 33208345 DOI: 10.1136/annrheumdis-2020-218467] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES No immunomodulatory drug has been approved for primary Sjögren's syndrome, a systemic autoimmune disease affecting 0.1% of the population. To demonstrate the efficacy of targeting interleukin 6 receptor in patients with Sjögren's syndrome-related systemic complications. METHODS Multicentre double-blind randomised placebo-controlled trial between 24 July 2013 and 16 July 2018, with a follow-up of 44 weeks, involving 17 referral centres. Inclusion criteria were primary Sjögren's syndrome according to American European Consensus Group criteria and score ≥5 for the EULAR Sjögren's Syndrome Disease activity Index (ESSDAI, score of systemic complications). Patients were randomised to receive either 6 monthly infusions of tocilizumab or placebo. The primary endpoint was response to treatment at week 24. Response to treatment was defined by the combination of (1) a decrease of at least 3 points in the ESSDAI, (2) no occurrence of moderate or severe activity in any new domain of the ESSDAI and (3) lack of worsening in physician's global assessment on a Visual Numeric Scale ≥1/10, all as compared with enrolment. RESULTS 110 patients were randomised, 55 patients to tocilizumab (mean (SD) age: 50.9 (12.4) years; women: 98.2%) and 55 patients to placebo (54.8 (10.7) years; 90.9%). At 24 weeks, the proportion of patients meeting the primary endpoint was 52.7% (29/55) in the tocilizumab group and 63.6% (35/55) in the placebo group, for a difference of -11.4% (95% credible interval -30.6 to 9.0) (Pr[Toc >Pla]=0.14). CONCLUSION Among patients with primary Sjögren's syndrome, the use of tocilizumab did not improve systemic involvement and symptoms over 24 weeks of treatment compared with placebo. TRIAL REGISTRATION NUMBER NCT01782235.
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Affiliation(s)
- Renaud Felten
- Rheumatology, CHU Strasbourg, Centre National de Référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO), Strasbourg, Alsace, France
| | | | - Raphaèle Seror
- Rheumatology, Université Paris-Sud BU Kremlin-Bicêtre, Le Kremlin-Bicetre, Île-de-France, France
| | - Pierre Duffau
- Internal Medicine, CHU de Bordeaux, Bordeaux, Aquitaine, France
| | - David Saadoun
- University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Eric Hachulla
- Internal Medicine, Regional and University Hospital Centre Lille Internal Medicine Service, Lille, Hauts-de-France, France
| | - Hatron Pierre Yves
- Internal Medicine, Regional and University Hospital Centre Lille Internal Medicine Service, Lille, Hauts-de-France, France
| | - Carine Salliot
- Rheumatology, Regional Hospital Centre Orleans La Source Hospital, Orleans, Centre, France
| | - Aleth Perdriger
- Rheumatology, University Hospital Centre Rennes, Rennes, Bretagne, France
| | - Jacques Morel
- CHU Lapeyronie, Montpellier, Languedoc-Roussillon, France
| | - Arsène Mékinian
- Internal Medicine, Hospital Saint-Antoine, Paris, Île-de-France, France
| | - Olivier Vittecoq
- Rheumatology, University Hospital Centre Rouen, Rouen, Normandie, France
| | | | | | | | - Philippe Dieudé
- Rheumatology, Hôpital Bichat Claude-Bernard, Paris, Île-de-France, France
| | - Claire Larroche
- Internal Medicine, Hospital Avicenne, Bobigny, Île-de-France, France
| | - Christophe Richez
- Rheumatology, CHU Bordeaux GH Pellegrin, Bordeaux, Aquitaine, France
| | - Thierry Martin
- Internal Medicine, CHU Strasbourg, Strasbourg, Alsace, France
| | - Charles Zarnitsky
- Rheumatology, Hôpital Jacques Monod, Montivilliers, Normandy, France
| | | | - Pierre Kieffer
- Internal Medicine, CH Mulhouse, Mulhouse, Grand Est, France
| | - François Maurier
- Internal Medicine, Sainte Blandine Hospital, Metz, Lorraine, France
| | - Azeddine Dellal
- Rheumatology, GHI Le Raincy-Montfermeil, Montfermeil, Île-de-France, France
| | - Stephanie Rist
- Rheumatology, Regional Hospital Centre Orleans La Source Hospital, Orleans, Centre, France
| | - Emmanuel Andres
- Internal Medicine, CHU Strasbourg, Strasbourg, Alsace, France
| | - Anne Contis
- Internal Medicine, CHU de Bordeaux, Bordeaux, Aquitaine, France
| | - Emmanuel Chatelus
- Rheumatology, CHU Strasbourg, Centre National de Référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO), Strasbourg, Alsace, France
| | - Christelle Sordet
- Rheumatology, CHU Strasbourg, Centre National de Référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO), Strasbourg, Alsace, France
| | - Jean Sibilia
- Rheumatology, CHU Strasbourg, Centre National de Référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO), Strasbourg, Alsace, France
| | | | - Mira Y Tawk
- DRCI, CHU Strasbourg, Strasbourg, Alsace, France
| | | | - Lise Holterbach
- Public Health, Methods in Clinical Research Team, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Patrice Cacoub
- University Hospital Pitié Salpêtrière, Paris, Île-de-France, France
| | - Alain Saraux
- Rheumatology, Hospital Cavale-Blanche, Brest, Bretagne, France
| | - Xavier Mariette
- Rheumatology, Université Paris-Sud BU Kremlin-Bicêtre, Le Kremlin-Bicetre, Île-de-France, France
| | - Nicolas Meyer
- Public Health, Methods in Clinical Research Team, Hopitaux universitaires de Strasbourg, Strasbourg, Alsace, France
| | - Jacques-Eric Gottenberg
- Rheumatology, CHU Strasbourg, Centre National de Référence des maladies auto-immunes et systémiques rares Est/Sud-Ouest (RESO), Strasbourg, Alsace, France
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9
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Meriglier E, Rivoisy C, Hessamfar M, Bernard N, Aureau I, Lapoirie J, Contis A, Sacher F, Sacristan B, Lahouati M, Pedeboscq S, Vandenhende MA, Bouchet S, Bonnet F. Safety of hydroxychloroquine and darunavir or lopinavir in COVID-19 infection. J Antimicrob Chemother 2021; 76:482-486. [PMID: 33221868 PMCID: PMC7717306 DOI: 10.1093/jac/dkaa441] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir has been suggested as an approach to improve the outcome of patients with moderate/severe COVID-19 infection. OBJECTIVES To examine the safety of combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. METHODS This was an observational cohort study of patients hospitalized for COVID-19 pneumonia treated with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Clinical evaluations, electrocardiograms and the pharmacokinetics of hydroxychloroquine, darunavir and lopinavir were examined according to clinical practice and guidelines. RESULTS Twenty-one patients received hydroxychloroquine with lopinavir/ritonavir (median age 68 years; 10 males) and 25 received hydroxychloroquine with darunavir/ritonavir (median age 71 years; 15 males). During treatment, eight patients (17.4%) developed ECG abnormalities. Ten patients discontinued treatment, including seven for ECG abnormalities a median of 5 (range 2-6) days after starting treatment. All ECG abnormalities reversed 1-2 days after interrupting treatment. Four patients died within 14 days. ECG abnormalities were significantly associated with age over 70 years, coexisting conditions (such as hypertension, chronic cardiovascular disease and kidney failure) and initial potential drug interactions, but not with the hydroxychloroquine concentration. CONCLUSIONS Of the patients with COVID-19 who received hydroxychloroquine with lopinavir or darunavir, 17% had ECG abnormalities, mainly related to age or in those with a history of cardiovascular disease.
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Affiliation(s)
- Etienne Meriglier
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
| | - Claire Rivoisy
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Mojgan Hessamfar
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Noelle Bernard
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Ines Aureau
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Joelle Lapoirie
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
| | - Anne Contis
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Frédéric Sacher
- Univ. Bordeaux, F-33000 Bordeaux, France.,IHU LIRYC, Université de Bordeaux, CHU de Bordeaux, Service de cardiologie, Hôpital Haut-Lévêque, F-33000 Bordeaux, France
| | | | - Marin Lahouati
- CHU de Bordeaux, Service de pharmacie clinique des médicaments, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Stéphane Pedeboscq
- CHU de Bordeaux, Service de pharmacie clinique des médicaments, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
| | - Stéphane Bouchet
- CHU de Bordeaux, Laboratoire de pharmacologie - toxicologie, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Fabrice Bonnet
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
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10
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Zannese T, Lapoirie J, Vandenhende M, Bonnet F, Contis A. Pneumopathie à Mycoplasma pneumoniae compliquée d’un PTI. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Lapoirie J, Contis A, Guy A, Lifermann F, Viallard JF, Sentilhes L, James C, Duffau P. Management and outcomes of 27 pregnancies in women with myeloproliferative neoplasms. J Matern Fetal Neonatal Med 2018; 33:49-56. [PMID: 29945475 DOI: 10.1080/14767058.2018.1484097] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Introduction: Philadelphia-negative myeloproliferative neoplasms (MPNs) greatly increase the risk of maternal and fetal complications during pregnancy. Currently, international agreements regarding the management of these women are lacking.Patients and methods: Our study aimed to assess the current management and outcomes of MPN pregnancies in a French cohort. We retrospectively analyzed 27 pregnancies in women with MPNs that were associated with a specific mutation. Nineteen pregnancies in nine women with essential thrombocythemia and eight pregnancies in five women with polycythemia vera were identified.Results: Our study showed 70% live births, but only 30% uneventful pregnancies. Fetal complications were mainly early spontaneous abortions (22%), fetal growth restriction (15%), and premature delivery (15%). Maternal issues were divided between thrombosis (15%) and hemorrhages (11%). High rates of preeclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome (15%) were reported. Uterine artery Doppler was performed in 70% pregnancies. Abnormal Doppler results were found in 43% pregnancies. Pregnancies with high platelet counts and packed cell volume remaining static or increasing ended with fetal death and utero-placental dysfunction. According to expert consensus, most of the pregnancies (67%) could be stratified in the high risk group and had a bad obstetrical outcome, with 50% standard-risk pregnancies versus 22% high-risk pregnancies that were uneventful. Higher risk pregnancies were prescribed heparin and/or interferon α in 72%.Conclusions: The prognosis of these pregnancies remains very bad and may be improved by a more effective collaboration between specialists as well as a therapeutic intensification including heparin and interferon α.
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Affiliation(s)
- Joëlle Lapoirie
- Department of Internal Medicine and Clinical Immunology, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France
| | - Anne Contis
- Department of Internal Medicine and Clinical Immunology, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France
| | - Alexandre Guy
- Laboratory of Hematology, Hôpital Haut-Lévèque, CHU de Bordeaux, Pessac, France.,INSERM U1034, Biology of Cardiovascular Diseases, Pessac, France
| | | | - Jean-François Viallard
- INSERM U1034, Biology of Cardiovascular Diseases, Pessac, France.,Department of Internal Medicine, Hôpital Haut-Lévèque, CHU de Bordeaux, Pessac, France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Chloé James
- Laboratory of Hematology, Hôpital Haut-Lévèque, CHU de Bordeaux, Pessac, France.,INSERM U1034, Biology of Cardiovascular Diseases, Pessac, France
| | - Pierre Duffau
- Department of Internal Medicine and Clinical Immunology, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France.,ImmunoConcept, UMR CNRS 5164, Université de Bordeaux, Pessac, France
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12
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Contis A, Mitrovic S, Lavie J, Douchet I, Lazaro E, Truchetet ME, Goizet C, Contin-Bordes C, Schaeverbeke T, Blanco P, Rossignol R, Faustin B, Richez C, Duffau P. Neutrophil-derived mitochondrial DNA promotes receptor activator of nuclear factor κB and its ligand signalling in rheumatoid arthritis. Rheumatology (Oxford) 2017; 56:1200-1205. [PMID: 28340056 DOI: 10.1093/rheumatology/kex041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Indexed: 12/31/2022] Open
Abstract
Objectives Mitochondrial DNA (mtDNA) contains sequestered damage-associated molecular patterns that might be involved in osteoimmunological pathogenesis of RA. Here, we aimed to investigate the cellular source of mtDNA and its role in RANK ligand (RANKL) expression by RA SF neutrophils. Methods The gene expression signature of SF neutrophils was examined by proteomic quantitative analysis. Levels of mtDNA in circulating and SF neutrophils from RA patients and OA control subjects were assessed by real-time PCR. Purified neutrophils were challenged in vitro with Toll-like receptor agonists as well as mtDNA. RANKL expression by neutrophils was studied by flow cytometry. Results SF neutrophils from RA patients displayed a gene expression signature of oxidative stress. This stress signature was associated with the release of mtDNA in SF as observed by a significant increase of mtDNA in the SF of RA patients compared with OA patients. mtDNA in RA SF was correlated with systemic inflammation as assessed by CRP concentrations. We also showed that mtDNA drives neutrophil RANKL expression to the same extent as Toll-like receptor agonists. Conclusion Our data identify SF neutrophils as a cellular source of mtDNA that leads to a subsequent expression of RANKL. This highlights the important role of neutrophils in RA osteoimmunology.
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Affiliation(s)
- Anne Contis
- ImmunoConcept, UMR CNRS 5164, Université de Bordeaux.,Service de médecine interne et immunologie clinique
| | - Stéphane Mitrovic
- ImmunoConcept, UMR CNRS 5164, Université de Bordeaux.,Service de rhumatologie, CHU de Bordeaux
| | - Julie Lavie
- INSERM EA4576, laboratoire MRGM, Université de Bordeaux
| | | | - Estibaliz Lazaro
- ImmunoConcept, UMR CNRS 5164, Université de Bordeaux.,Service de médecine interne, CHU de Bordeaux
| | | | - Cyril Goizet
- INSERM U1211, laboratoire MRGM, Université de Bordeaux.,Service de génétique médicale
| | - Cécile Contin-Bordes
- ImmunoConcept, UMR CNRS 5164, Université de Bordeaux.,Laboratoire d'immunologie, CHU de Bordeaux, Bordeaux, France
| | | | - Patrick Blanco
- ImmunoConcept, UMR CNRS 5164, Université de Bordeaux.,Laboratoire d'immunologie, CHU de Bordeaux, Bordeaux, France
| | | | | | - Christophe Richez
- ImmunoConcept, UMR CNRS 5164, Université de Bordeaux.,Service de rhumatologie, CHU de Bordeaux
| | - Pierre Duffau
- ImmunoConcept, UMR CNRS 5164, Université de Bordeaux.,Service de médecine interne et immunologie clinique
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13
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Prot C, Contis A, Ribeiro E. Dermatomyosite à anticorps anti-TIF1 gamma paranéoplasique d’un lymphome B diffus à grandes cellules : à propos d’un cas. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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Contis A, Gensous N, Viallard J, Goizet C, Léauté-Labrèze C, Duffau P. Efficacy and safety of propranolol for epistaxis in hereditary haemorrhagic telangiectasia: retrospective, then prospective study, in a total of 21 patients. Clin Otolaryngol 2017; 42:911-917. [DOI: 10.1111/coa.12821] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 11/28/2022]
Affiliation(s)
- A. Contis
- Service de médecine interne et immunologie clinique; Hôpital Saint André; Bordeaux France
| | - N. Gensous
- Service de médecine interne et immunologie clinique; Hôpital Saint André; Bordeaux France
| | - J.F. Viallard
- Service de médecine interne; Hôpital Haut- Lévêque; Pessac France
| | - C. Goizet
- Service de génétique médicale; Hôpital Pellegrin; Bordeaux France
| | - C. Léauté-Labrèze
- Service de dermatologie pédiatrique et Centre de référence maladies rares de la peau; Hôpital Pellegrin; Bordeaux France
| | - P. Duffau
- Service de médecine interne et immunologie clinique; Hôpital Saint André; Bordeaux France
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15
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Contis A, Ribeiro E, Martinez C, Duffau P, Mercié P. Une hypertension artérielle paranéoplasique : à propos d’un cas de sarcome rétropéritonéal. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Ducombs M, Contis A, Ribeiro E, Martinez C, Duffau P, Mercié P. Myopéricardite et pseudopolyarthrite rhizomélique au cours d’une rectocolite hémorragique : un effet secondaire rare de la mesalazine. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Mitrovic S, Contis A, Faustin B, Rossignol R, Goizet C, Truchetet ME, Lazaro E, Contin-Bordes C, Duffau P, Richez C. THU0049 Involvement of Mitochondrial DNA in Rheumatoid Arthritis Pathogenesis Through Up-Regulation of RANK-L Expression by Neutrophils. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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18
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Aguerre C, Contis A, Ribeiro E, Martinez C, Duffau P, Mercié P. Entéropathie à l’olmesartan. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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19
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Ribeiro E, Contis A, Martinez C, Duffau P, Mercié P. Une choriorétinite bilatérale révélant un myélome multiple. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Mercier A, Duffau P, Martinez C, Ribeiro E, Contis A, Mercié P. Syphilis oculaire. Une atteinte est possible quel que soit le degré d’immunodépression : à propos de 2 observations. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Ribeiro E, Combillet F, Ezzedine K, Contis A, Martinez C, Duffau P, Malvy D, Rougier M, Mercié P. Une bilharziose invasive mimant de manière exceptionnelle une maladie systémique. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Contis A, Lazaro E, Greib C, Pellegrin JL, Viallard JF. Romiplostim as early treatment for refractory primary immune thrombocytopenia. Int J Hematol 2013; 98:520-4. [DOI: 10.1007/s12185-013-1439-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 09/07/2013] [Accepted: 09/09/2013] [Indexed: 01/06/2023]
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23
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Puyade M, Contis A, Saunier A, Narain Sookool U, Greib C, Pellegrin JL, Viallard JF, Seneschal J, Lazaro E. Une gammapathie payée rubis sur ongle. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Roger-Schmeltz J, Contis A, Ribeiro E, Mercie P, Malvy D, Longy-Boursier M. Syndrome de Mounier-Khun : cause d’infections respiratoires itératives. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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Contis A, Créoff P, Lorand V, Ortega J, Warnet A. [The nurse's role in pituitary testing]. Soins 1988:15-8. [PMID: 3187590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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26
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Ortega J, Contis A, Dutey H, Guillausseau PJ. [Prevention of the diabetic food and its complications]. Soins 1987:15-8. [PMID: 3647604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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